On the pulse

At the RCN Congress in Liverpool this week, some of the most pressing issues facing the nursing profession were on the agenda. In particular, two stories covered by Nursing Times highlighted the need for greater awareness of the value of some nursing roles.

Community nurses ‘under real pressure’ from chronic wound care

Nurses in the UK carry out 180 wound dressing changes a year on each patient with a chronic wound, a survey has indicated.

It also suggested that chronic wounds, such as diabetic foot ulcers, pressure ulcers and venous leg ulcers, take more than eight months to heal for the average patient.

“Community nurses are really under pressure when it comes to wound patients”

Una Adderley

Despite advancements in wound care, patients report dressings are changed on average five times a week, according to the survey of more than 200 people living with chronic wounds.

The research was carried out by Opinion Matters, on behalf of wound care treatment company Mölnlycke, between 29 June and 9 July this year.

It included 201 men and women aged 18-70 who were currently receiving, or had received in the last five years, treatment for a wound that was not expected to heal or had not healed in four weeks.

Those behind the survey said the findings from it had revealed that living with an open wound for almost a year had become the “new normal” in the UK.

The situation was “challenging” for nurses and had a “devastating impact” on the quality of life for those patients affected, they noted.

The survey found that the average patient with a chronic wound was affected for over eight months, with an estimated 300,000 – equivalent to 11% – patients going beyond the one year mark.

“It is becoming increasingly difficult for these nurses to give patients the time and care they need”

Una Adderley

The majority, around 80%, of patients required dressing changes at least twice a week and 35% required daily dressing changes.

As a result, those behind the survey said it was “sadly unsurprising to discover” that over a third of patients reported their wound had a high impact on their quality of life.

One in four had their dressing changed by a nurse at their local GP surgery and 4% by a specialist nurse, such as a tissue viability nurse, at a wound care clinic.

However, the survey found 20% of patients who took part reported being dependent on nurses or healthcare assistants visiting them at home, up to seven days a week.

Living with a chronic wound had a huge impact on patients’ lives, with 30% reporting feeling “powerless” and 23% reporting feeling depressed, the research found.

It indicated tat the burden of living with a wound affected patient’s lives on a day-to-day basis, with 18% unable to work full time and a further 15% unable to work at all.

In addition, it showed that living with a wound could lead to social isolation, with 26% seeing friends or family less and 48% struggling to exercise or walk for long periods.

Dr Una Adderley

Una Adderley

Meanwhile, it suggested many patients additionally relied on pain killers (33%) or sleeping pills (10%) to ease their discomfort. Some patients even reported needing anti-depressants (13%) to cope.

Dr Una Adderley, a lecturer in community nursing at the University of Leeds, said: “Community nurses, such as practice nurses and district nurses, are really under pressure when it comes to wound patients.

“Wound care forms a large part of the nursing caseload and it is becoming increasingly difficult for these nurses to give patients the time and care they need,” said Dr Adderley, who leads the Legs Matter coalition, which campaigns for better wound care.

She added: “In this study, patients report an average dressing time of 18 minutes, but this is rarely enough time to provide the care that is needed.

“When nurses have more time with each patient to give good quality assessment and appropriate care, we see better healing and improved patient quality of life,” she said.

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